The Relationship Between Proton Pump Inhibitor Adherence and Fracture Risk in the Elderly
| Autor: | Theresa V. Brown, Frank M. Ahern, Debra A. Heller, Jian Ding |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Medication Adherence Cohort Studies Fractures Bone Endocrinology Risk Factors Internal medicine medicine Humans Orthopedics and Sports Medicine Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Incidence (epidemiology) Hazard ratio Proton Pump Inhibitors Retrospective cohort study medicine.disease Comorbidity Surgery Cohort Female business Body mass index Cohort study |
| Zdroj: | Calcified Tissue International. 94:597-607 |
| ISSN: | 1432-0827 0171-967X |
| DOI: | 10.1007/s00223-014-9855-6 |
| Popis: | Studies suggest that long-term use of proton pump inhibitors (PPIs) may be associated with an increased risk of fracture. However, the role of medication adherence in this association is not fully understood. A retrospective cohort study was conducted to examine the relationship between PPI use/adherence and fracture risk among elderly subjects by combining administrative pharmacy claims data, survey data, and Medicare data. The study cohort included 1,604 PPI users and 23,672 nonusers who were enrolled in Pennsylvania’s Pharmaceutical Assistance Contract for the Elderly program. PPI adherence was measured by the proportion of days covered (PDC). Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of PPI use/adherence for fracture risk while controlling for demographics, comorbidity, body mass index, smoking, and non-PPI medication use. The overall incidence of any fracture per 100 person-years was 8.7 for PPI users and 5.0 for nonusers. A gradient in fracture risk according to PPI adherence was observed. Relative to nonusers, fracture HRs associated with the highest (PDC ≥ 0.80), intermediate (PDC 0.40–0.79), and lowest (PDC |
| Databáze: | OpenAIRE |
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